Censured for faking codeine scripts

A New Zealand pharmacist has been censured after she created false codeine prescriptions and had them filled

The New Zealand Health Practitioners’ Discliplinary Tribunal heard a charge of professional misconduct against the pharmacist, identified only as Ms E, alleging that she conducted herself in a dishonest and/or unprofessional manner on a number of occasions.

These included four incidents in November and December 2015.

In the first, she created a false prescription in the name of her husband for 100 x 60mg codeine phosphate tablets.

A few days later she presented the script at a pharmacy and was dispensed 200 x 30mg codeine phosphate tablets by another pharmacist (Ms U), who had been a friend of hers since they studied pharmacy together.

Later that month, Ms E created another false prescription, this time in the name of a second friend (Ms B) for 60 x 60mg tablets, and presented it a few days later at a different store.

But the dispensing pharmacist became suspicious of the prescription due to the strength of the medication, and the way the script looked.

While Ms E waited for it to be filled, he rang a practice nurse to confirm whether it was genuine – and she told him that no prescriptions had been issued for Ms B on the date on the prescription.

The pharmacist advised Ms E that he would not dispense the medication, and she asked whether this was due to the high strength.

He told her that he would not disclose why he was refusing the script, and after she left – after purchasing nasal spray and chocolate – the pharmacist obtained a still image of her from the store’s CCTV, which he then supplied, with the prescription, to the police.

The police circulated an email entitled “potential codeine shopper” to pharmacies which were involved in a theft prevention initiative.

Ms U recognised her friend and emailed the Registrar of the Pharmacy Council, including a copy of the CCTV picture sent to her by a pharmacist in Wellington and advising that she also had a forged prescription for codeine in Ms E’s husband’s name.

The Council imposed interim conditions on Ms E’s scope of practice, restricting her ability to practise until further notice.

The pharmacist was arrested and charged with forgery and knowingly using forged prescriptions under the Crimes Act, and pleaded guilty to the charges.

While she was discharged without conviction by the District Court, a disciplinary charge before the Tribunal was still required, it said, for the protection of the public and the maintenance of the high professional standards expected of health practitioners.

The Tribunal heard Ms E’d mental health history, including a “nervous breakdown” in late 2013 due to “multiple serious stressors” including financial and health problems.

After being prescribed quetiapine, her condition improved, but worsened again in September 2015 when she was subjected to workplace bullying.

She told an assessing psychiatrist that she felt “very stressed and low in mood and had become suicidal,” and that she wrote a number of prescriptions with an intent to overdose.

However she had not disclosed her mental health issues to the Council before her August 2016 District Court hearing, and the Council only learned of them because a staff member had attended the court hearing.

The report stated that Ms E’s mental illness had impaired her ability to think clearly, and that it appeared the behaviour was out of character and she was remorseful.

“It was on the strength of this report that the practitioner had been discharged without conviction by the District Court,” the Tribunal noted.

Since then, she had accessed counselling and support through maternal mental health services and was “much improved”.

The Tribunal found that it had no difficulty in determining that Ms E’s conduct in creating, and presenting, two false scripts at two pharmacies, was conduct which fell “well short” of that expected of a competent pharmacist.

The pharmacist was censured and conditions were imposed upon her recommencing practice in the profession. She was ordered to pay 25% of the court costs, at NZ$9,800 (AUD$8991).

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